4926 Johnson Dr., Shawnee Mission, KS 66205
Office Hours: Monday-Friday 9-5
Available by phone 24/7
913-384-5566

Vital Statistics Form

Please fill this form out as much as possible. It will help us to complete the death certificate and in writing the obituary. All fields with an asterisk are required.

Deceased's Information

If residence, please include address
mm/dd/yyyy
English, Irish, French, German, etc.
Be specific
Primary occupation during working years. *Do not enter \"retired\".
Sales, Medical, Engineering, Construction, etc.
Please list survivors and relationship: son, daughter, brother, sister, etc.
Religious affiliations, fraternal and civic organizations, hobbies, etc.

Informant's Information

A copy of what is submitted will be sent to this email.
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Obituaries & Condolences

James H. Hammack

Marian “Dilly” Long Kenney

Anna Belle (Kirch) Johnson

Pamela D. Simpson

Nicholas Eugene Woods

Wanda L. McDonald

Darrel Eugene Davidson

Betty Louise Heryford

Judith L. Cornish

J. Alex Huddleston

Juanita (Sally) Elkins

Robert Patten